Bacterial meningitis in North India: Trends over a period of eight years
- Author:
Fatima Khan
;
Meher Rizvi
;
Nazish Fatima
;
Indu Shukla
;
Abida Malik
;
Razia Khatoon
- Publication Type:Journal Article
- From:Neurology Asia
2011;16(1):47-56
- CountryMalaysia
- Language:English
-
Abstract:
Background: Acute bacterial meningitis is a medical emergency which warrants early diagnosis and
aggressive therapy. It is important to know the regional bacterial etiology in semitropical countries
like India along with their sensitivity profi le to allow optimum management of such patients with least
possible mortality. This study was undertaken to study the trends in etiology and the antimicrobial
resistance pattern of the pathogens prevalent in North India over a period of 8 years. Methods: The
study was performed from June 2001 to June 2009. CSF and blood samples were collected from all
patients suspected of meningitis and inoculated on chocolate agar, blood agar and MacConkey agar.
Antimicrobial susceptibility testing was done using Kirby Bauer disc diffusion method. Detection of
methicillin resistant Staphylococcus aureus (MRSA), high level aminoglycoside resistance (HLAR) in
Enterococcus species, extended spectrum β lactamases (ESBL), Amp C and metallo-betalactamases was
also done. Results: 403 samples were positive on culture. S. aureus was the most common pathogen.
Among the gram positive cocci as well as the gram negative bacilli, a gradual decline in the antimicrobial
susceptibility was seen. The aminoglycosides had the best spectrum of antimicrobial activity. Towards
the end of the study, an alarming rise of MRSA to 69.4%, HLAR among the Enterococci to 60% was
noted. Among the Enterobacteriaceae, ESBL and Amp C production was found to be 16.7% and 42%
respectively. No vancomycin and imipenem resistance was observed.
Conclusion: An entirely different trend in etiology in bacterial meningitis was observed in the
semitropical region of North India. The high prevalence of drug resistant pathogens is a cause for
worry and should be dealt with by rational use of antimicrobials. Frequent revision in drug policy
may be necessitated for optimum management of patients.
- Full text:P020150731419137105852.pdf
